Al Roker on Dumping Syndrome

By Madeline Vann, MPH | Medically reviewed by Farrokh Sohrabi, MD

This bariatric surgery side effect with a double meaning causes your stomach contents to be dumped quickly into your intestines, causing uncontrollable diarrhea. Learn how to manage this uncomfortable situation.

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It’s been more than a decade since weatherman and TV
personality Al Roker experienced a mortifying mishap at the White House.
Nonetheless, his experience with an unexpected episode of dumping syndrome, also
called “rapid gastric emptying,” went viral after he noted it — to
highlight the downside of gastric
bypass surgery — in his new book, Never Goin’
Back. Roker's very public admission ignited conversation about the
side effect, in which stomach contents move rapidly from the stomach to the
intestine and colon, causing abdominal cramping and diarrhea.

As bariatric surgery for weight loss gains in popularity,
side effects such as dumping syndrome require attention, especially because they’re
connected to nutritional deficiencies that need to be anticipated and
corrected, according to a study published in Digestive Diseases.
They're also not rare occurrences. When researchers at Ohio State University followed 50 people who'd had gastric
bypass surgery, they found that about 42 percent experienced dumping syndrome.

“I think Al Roker
has done an amazing thing,” says gastroenterologist David Greenwald, MD, professor of clinical medicine at the Albert
Einstein College of Medicine in the Bronx, N.Y. “He’s lost a
tremendous amount of weight and been very public with it all, letting people
know his weight loss is a lifelong commitment.”

And while dumping syndrome is a possible result of
bariatric surgery, Dr. Greenwald says that the weight loss benefits of
bariatric surgery, especially for someone facing the very real health risks of
obesity, far outweigh this manageable concern.

Dumping
Syndrome Defined

“Dumping syndrome is a group of symptoms that relate to
rapid emptying of stomach contents,” explains Greenwald. The reason that
dumping syndrome occurs along with bariatric surgery is that the surgery can
affect the pyloris, a small sphincter muscle that usually prevents your stomach
contents from moving on before they're adequately digested.

Symptoms,
which usually occur during or right after a meal, include nausea, vomiting, bloating,
cramping, diarrhea, dizziness, and fatigue.

A related condition, called late rapid gastric emptying,
occurs one to three hours after eating. Symptoms of late rapid gastric emptying
include low blood sugar, sweating, dizziness, and weakness. People can
experience both the regular and the late versions of rapid gastric emptying.

The primary cause of dumping syndrome is stomach surgery,
such as bariatric surgery, that affects the anatomy of the stomach. However,
some people develop dumping syndrome because of a rare condition called
Zollinger-Ellison syndrome, in which tumors, sometimes cancerous, in the
pancreas and small intestine lead to intestinal ulcers.

Coping
With Dumping Syndrome

If you experience dumping syndrome, you want solutions
that will keep you comfortable and help avoid embarrassing moments. Greenwald
recommends these strategies:

Eat
small meals. If you eat small amounts more
frequently, you won’t have as much food volume to move out of your stomach,
lessening the ill effects of dumping syndrome.

Drink
between meals, not during meals. “Fluids move solids along,” points out
Greenwald. So sip fluids between meals and skip the beverage with a meal.

Cut
down on sugar. Added and natural sugars both seem to
aggravate dumping syndrome. Your symptoms may improve by cutting out sugars,
including lactose found in dairy.

Take
medications. Your doctor may be able to prescribe
medications that will slow your digestive process to avoid dumping syndrome.

Consider
surgery in severe situations. Some people may need surgery to restructure
the anatomical changes that have led to dumping syndrome.

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